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1.
Julien Garnon Guillaume Koch Nitin Ramamurthy Jean Caudrelier Pramod Rao Georgia Tsoumakidou Roberto Luigi Cazzato Afshin Gangi 《Cardiovascular and interventional radiology》2016,39(9):1332-1338
Objective
To review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and Methods
Between May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.Results
Four pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.Conclusion
Percutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.2.
Kazuya Yasokawa Katsuyoshi Ito Tsutomu Tamada Akira Yamamoto Minoru Hayashida Teruyuki Torigoe Daigo Tanimoto Atsushi Higaki Yasufumi Noda Ayumu Kido 《European radiology》2016,26(12):4339-4344
Purpose
To evaluate the influence of oral ingestion on the secretory flow dynamics of physiological pancreatic juice within the main pancreatic duct in healthy subjects by using cine-dynamic MRCP with spatially-selective inversion-recovery (IR) pulse non-invasively.Materials and methods
Thirty-eight healthy subjects were investigated. MRCP with spatially-selective IR pulse was repeated every 15 s for 5 min to acquire a total of 20 images (cine-dynamic MRCP). A set of 20 MRCP images was repeatedly obtained before and after liquid oral ingestion every 7 min (including 2-min interval) for 40 min (a total of seven sets). Secretion grade of pancreatic juice on cine-dynamic MRCP was compared before and after oral ingestion using the nonparametric Wilcoxon signed-rank test.Results
Median secretion grades of pancreatic juice at 5 min (score?=?2.15), 12 min (score?=?1.95) and 19 min (score?=?2.05) after ingestion were significantly higher than that before ingestion (score?=?1.40) (P?=?0.004, P?=?0.032, P?=?0.045, respectively). Secretion grade of pancreatic juice showed a maximum peak of 2.15 at 5 min after ingestion. Thereafter, the secretion grade of pancreatic juice tended to gradually decline.Conclusion
Non-invasive cine-dynamic MRCP using spatially-selective IR pulse showed potential for evaluating postprandial changes in the secretory flow dynamics of pancreatic juice as a physiological reaction.Key Points
? Secretion grade of pancreatic juice at cine-dynamic MRCP after ingestion was evaluated. ? Secretion grade was significantly increased within 19 min after liquid meal ingestion. ? Secretion grade showed maximum peak of 2.15 at 5 min after ingestion. ? Postprandial changes in pancreatic juice flow can be assessed by cine-dynamic MRCP.3.
Objectives
Thoracic spine radiography becomes more difficult with age. Tomosynthesis is a low-dose tomographic extension of radiography which may facilitate thoracic spine evaluation. This study assessed the added value of tomosynthesis in imaging of the thoracic spine in the elderly.Methods
Four observers compared the image quality of 50 consecutive thoracic spine radiography and tomosynthesis data sets from 48 patients (median age 67 years, range 55–92 years) on a number of image quality criteria. Observer variation was determined by free-marginal multirater kappa. The conversion factor and effective dose were determined from the dose–area product values.Results
For all observers significantly more vertebrae were seen with tomosynthesis than with radiography (mean 12.4/9.3, P?<?0.001) as well as significantly more fractures (mean 0.9/0.7, P?=?0.017). The image quality score for tomosynthesis was significantly higher than for radiography, for all evaluated structures. Tomosynthesis took longer to evaluate than radiography. Despite this, all observers scored a clear preference for tomosynthesis. Observer agreement was substantial (mean κ?=?0.73, range 0.51–0.94). The calibration or conversion factor was 0.11 mSv/(Gy cm2) for the combined examination. The resulting effective dose was 0.87 mSv.Conclusion
Tomosynthesis can increase the detection rate of thoracic vertebral fractures in the elderly, at low added radiation dose.Key Points
? Tomosynthesis helps evaluate the thoracic spine in the elderly. ? Observer agreement for thoracic spine tomosynthesis was substantial (mean κ?=?0.73). ? Significantly more vertebrae and significantly more fractures were seen with tomosynthesis. ? Tomosynthesis took longer to evaluate than radiography. ? There was a clear preference among all observers for tomosynthesis over radiography.4.
Kristina Lång Matilda Nergården Ingvar Andersson Aldana Rosso Sophia Zackrisson 《European radiology》2016,26(11):3899-3907
Objectives
To analyse false positives (FPs) in breast cancer screening with tomosynthesis (BT) vs. mammography (DM).Methods
The Malmö Breast Tomosynthesis Screening Trial (MBTST) is a prospective population-based study comparing one-view BT to DM in screening. This study is based on the first half of the MBTST population (n?=?7,500). Differences in FP recall rate, findings leading to recall, work-up and biopsy rate between cases recalled on BT alone, DM alone and BT+DM were analysed.Results
The FP recall rate was 1.7 % for BT alone (n?=?131), 0.9 % for DM alone (n?=?69) and 1.1 % for BT?+?DM (n?=?81). The FP recall rate for BT alone was halved after the initial phase of the trial, stabilising at 1.5 %. BT doubled the recall of stellate distortions compared to DM (n?=?64 vs. n?=?33). There were fewer fibroadenomas and cysts, and the biopsy rate was slightly lower for FP recalled on BT alone compared to DM alone (15.3 % vs. 27.6 %: p?=?0.037 and 33.8 % vs. 36.2 %; p?=?0.641, respectively).Conclusions
FPs increased with BT screening mainly due to the recall of stellate distortions. The FP recall rate was still well within the European guidelines and showed evidence of a learning curve. Characterisation of rounded lesions was improved with BT.Key Points
? Tomosynthesis screening gave a higher false-positive recall rate than mammography ? There was a decline in the false-positive recall rate for tomosynthesis ? The recall due to stellate distortions simulating malignancy was doubled with tomosynthesis ? Tomosynthesis found more radial and postoperative scar tissue than mammography ? Tomosynthesis is better at characterising rounded lesions5.
Yet Yen Yan Jenn Nee Khoo Tien Jin Tan Joe Francis Le Roy Chong Elizabeth Hui-Ying Chan 《Emergency radiology》2018,25(4):399-406
Purpose
To review the errors made by radiology trainees in the reporting of cervical spine CTs (CCT) and to compare the discrepancy rates between the stages of training.Methods
All CCTs reported by trainees after office hours between January 2015 and December 2015 were retrospectively reviewed by a team of five musculoskeletal consultants with experience ranging between 7 and 15 years. Discrepancies between the provisional report by the trainee and the findings by the musculoskeletal consultants were graded according to the RADPEER scoring system. Sensitivity and specificity of the trainees were assessed.Results
Of 254 CCT provisional reports, there were 12 (4.7%) discrepancies, of which 5 (2.0%) discrepancies were likely to be clinically significant. We found a clinically significant difference between the stage of training of the trainee and RADPEER score (P?=?0.023). The sensitivity and specificity of the senior radiology trainees were 97.0 and 98.1%, respectively, and that of the junior radiology trainees were 80 and 98.0% respectively (P?=?0.039). Conditions misinterpreted as fractures include degenerative changes (n?=?2) and nutrient vessel (n?=?1). Other missed abnormalities include ossification of the posterior longitudinal ligament (n?=?1), fracture of the foramen transversarium (n?=?2), vertebral body fractures (n?=?2), articular facet fractures (n?=?2), and transverse process fractures (n?=?2).Conclusion
Cervical spine CTs performed after office hours can be safely interpreted by senior radiology trainees to a reasonable degree, although a targeted intervention to improve diagnostic performance of junior radiology trainees may be of clinical benefit.6.
Objectives
To evaluate the associations between breast glandular tissues diameters as determined by CT and b-hCG levels, histological types, tumour spread and prognosis in patients with testicular germ cell tumour.Methods
Ninety-four patients with pre-treatment CT scan and markers (b-hCG, AFP, LDH) were retrospectively collected. A radiologist measured diameters in all CT examinations and correlation between diameters and log (b-hCG) was assessed (Pearson’s coefficient). The ability of measured diameters to predict lymphatic and distant haematogenous metastatic spread was evaluated (ROC curves). The associations between measured diameter cut-off values of 20 and 25 mm and International Germ Cell Cancer Collaborative Group (IGCCCG) classification, lymphatic and distant haematogenous metastatic spread and histological subtypes were evaluated (chi squared test).Results
Breast glandular diameters correlated to log(b-hCG) (r?=?0.579) and predicted distant haematogenous metastatic spread (AUC?=?0.78). Worse prognosis (intermediate or poor IGCCCG) was shown for 20 mm (27.3 vs. 4.2 %, p?=?0.005) and 25 mm (33.3 vs. 6.1 %, p?=?0.014). A diameter of 25 mm was associated with non-seminoma (91.7 vs. 48.8 %, p?=?0.005).Conclusion
Breast glandular tissue diameters correlated with log(b-hCG) and predicted distant haematogenous metastases. Twenty and 25 mm were associated with worse prognosis and 25 mm was able to distinguish between seminoma and non-seminoma.Key Points
? CT breast glandular tissue diameter correlates with log(b-HCG) ? Gynaecomastia in CT is associated with worse prognosis ? Gynaecomastia in CT is associated with non-seminoma histological subtype7.
Hervé Gouya Sophie Grabar Olivier Vignaux Anastasia Saade Stanislas Pol Paul Legmann Philippe Sogni 《European radiology》2016,26(7):1981-1990
Objectives
To measure azygos, portal and aortic flow by two-dimensional cine phase-contrast magnetic resonance imaging (2D-cine PC MRI), and to compare the MRI values to hepatic venous pressure gradient (HVPG) measurements, in patients with cirrhosis.Methods
Sixty-nine patients with cirrhosis were prospectively included. All patients underwent HVPG measurements, upper gastrointestinal endoscopy and 2D-cine PC MRI measurements of azygos, portal and aortic blood flow. Univariate and multivariate regression analyses were used to evaluate the correlation between the blood flow and HVPG. The performance of 2D-cine PC MRI to diagnose severe portal hypertension (HVPG?≥?16 mmHg) was determined by receiver operating characteristic curve (ROC) analysis, and area under the curves (AUC) were compared.Results
Azygos and aortic flow values were associated with HVPG in univariate linear regression model. Azygos flow (p?<?10-3), aortic flow (p?=?0.001), age (p?=?0.001) and presence of varices (p?<?10-3) were independently associated with HVPG. Azygos flow (AUC?=?0.96 (95 % CI [0.91–1.00]) had significantly higher AUC than aortic (AUC?=?0.64 (95 % CI [0.51–0.77]) or portal blood flow (AUC?=?0.40 (95 % CI [0.25–0.54]).Conclusions
2D-cine PC MRI is a promising technique to evaluate significant portal hypertension in patients with cirrhosis.Key Points
? Noninvasive HVPG assessment can be performed with MRI azygos flow. ? Azygos MRI flow is an easy-to-measure marker to detect significant portal hypertension. ? MRI flow is more specific that varice grade to detect portal hypertension.8.
Sang Min Lee Jin Mo Goo Chang Min Park Soon Ho Yoon Jin Chul Paeng Gi Jeong Cheon Young Tae Kim Young Sik Park 《European radiology》2016,26(11):3850-3857
Objectives
To prospectively compare the accuracies of PET/MR and PET/CT in the preoperative staging of non-small cell lung cancer (NSCLC).Methods
Institutional review board approval and patients’ informed consents were obtained. 45 patients with proven or radiologically suspected lung cancer which appeared to be resectable on CT were enrolled. PET/MR was performed for the preoperative staging of NSCLC followed by PET/CT without contrast enhancement on the same day. Dedicated MR images including diffusion weighted images were obtained. Readers assessed PET/MR and PET/CT with contrast-enhanced CT. Accuracies of PET/MR and PET/CT for NSCLC staging were compared.Results
Primary tumour stages (n?=?40) were correctly diagnosed in 32 patients (80.0 %) on PET/MR and in 32 patients (80.0 %) on PET/CT (P?=?1.0). Node stages (n?=?42) were correctly determined in 24 patients (57.1 %) on PET/MR and in 22 patients (52.4 %) on PET/CT (P?=?0.683). Metastatic lesions in the brain, bone, liver, and pleura were detected in 6 patients (13.3 %). PET/MR missed one patient with pleural metastasis while PET/CT missed one patient with solitary brain metastasis and two patients with pleural metastases (P?=?0.480).Conclusions
This study demonstrated that PET/MR in combination with contrast-enhanced CT was comparable to PET/CT in the preoperative staging of NSCLC while reducing radiation exposure.Key points
? PET/MR can be comparable to PET/CT for preoperative NSCLC staging.? PET/MR and PET/CT show excellent correlation in measuring SUVmax of primary lesions.? Using PET/MR, estimated radiation dose can decrease by 31.1?% compared with PET/CT.9.
Vivan J. M. Baggen Tim Leiner Marco C. Post Arie P. van Dijk Jolien W. Roos-Hesselink Eric Boersma Jesse Habets Gertjan Tj. Sieswerda 《European radiology》2016,26(11):3771-3780
Objectives
To provide a comprehensive overview of all reported cardiac magnetic resonance (CMR) findings that predict clinical deterioration in pulmonary arterial hypertension (PAH).Methods
MEDLINE and EMBASE electronic databases were systematically searched for longitudinal studies published by April 2015 that reported associations between CMR findings and adverse clinical outcome in PAH. Studies were appraised using previously developed criteria for prognostic studies. Meta-analysis using random effect models was performed for CMR findings investigated by three or more studies.Results
Eight papers (539 patients) investigating 21 different CMR findings were included. Meta-analysis showed that right ventricular (RV) ejection fraction was the strongest predictor of mortality in PAH (pooled HR 1.23 [95 % CI 1.07–1.41], p?=?0.003) per 5 % decrease. In addition, RV end-diastolic volume index (pooled HR 1.06 [95 % CI 1.00–1.12], p?=?0.049), RV end-systolic volume index (pooled HR 1.05 [95 % CI 1.01–1.09], p?=?0.013) and left ventricular end-diastolic volume index (pooled HR 1.16 [95 % CI 1.00–1.34], p?=?0.045) were of prognostic importance. RV and LV mass did not provide prognostic information (p?=?0.852 and p?=?0.983, respectively).Conclusion
This meta-analysis substantiates the clinical yield of specific CMR findings in the prognostication of PAH patients. Decreased RV ejection is the strongest and most well established predictor of mortality.Key Points
? Cardiac magnetic resonance imaging is useful for prognostication in pulmonary arterial hypertension.? Right ventricular ejection fraction is the strongest predictor of mortality.? Serial CMR evaluation seems to be of additional prognostic importance.? Accurate prognostication can aid in adequate and timely intensification of PAH-specific therapy.10.
Barbara?Geeroms Wim?Laleman Annouschka?Laenen Sam?Heye Chris?Verslype Schalk?van der?Merwe Frederik?Nevens Geert?Maleux
Purpose
To retrospectively analyse long-term patency and overall survival of cirrhotic patients treated with TIPSS using e-PTFE-covered stents. Additionally, prognostic factors for better patency and survival were analysed.Materials and methods
Two hundred and eighty-five consecutive cirrhotic patients with severe portal hypertension-related symptoms were included. Follow-up, including clinical assessment and duplex ultrasound, was analysed up to end of study, patient’s death, liver transplantation or TIPSS-reduction. Patency rates and overall survival were estimated by the Kaplan-Meier method; potential differences in outcome between subgroups were calculated using the Pepe and Mori test.Results
The 1-, 2- and 5-year primary patencies were 91.5 %, 89.2 % and 86.2 %, respectively, with no new shunt dysfunctions after 5 years’ follow-up. TIPSS revision was performed more often in ascites patients (P?=?0.02). The 1-, 4- and 10-year survival rates were 69.2 %, 52.1 % and 30.7 %, respectively. Survival was higher in Child-Pugh class A-B (P?=?0.04), in the recurrent bleeding group (P?=?0.008) and in patients with underlying alcoholic cirrhosis (P?=?0.01).Conclusion
Long term, primary patency of e-PTFE-covered TIPSS stents remains very high (>80 %); shunt revision was required more frequently in ascites patients. Overall survival was better in Child-Pugh A-B patients with recurrent variceal bleeding and alcoholic liver cirrhosis.Keypoints
? Long-term primary patency rate of e-PTFE-covered TIPSS stents remains very high. ? No new shunt dysfunction was found after 5 years of follow-up. ? Shunt revision was required more frequently in ascites patients. ? Four and 10 years’ overall survival was 50 and 30 %, respectively.11.
Objectives
Deep medullary veins support the venous drainage of the brain and may display abnormalities in the context of different cerebrovascular diseases. We present and evaluate a method to automatically detect and quantify deep medullary veins at 7 T.Methods
Five participants were scanned twice, to assess the robustness and reproducibility of manual and automated vein detection. Additionally, the method was evaluated on 24 participants to demonstrate its application. Deep medullary veins were assessed within an automatically created region-of-interest around the lateral ventricles, defined such that all veins must intersect it. A combination of vesselness, tubular tracking, and hysteresis thresholding located individual veins, which were quantified by counting and computing (3-D) density maps.Results
Visual assessment was time-consuming (2 h/scan), with an intra-/inter-observer agreement on absolute vein count of ICC?=?0.76 and 0.60, respectively. The automated vein detection showed excellent inter-scan reproducibility before (ICC?=?0.79) and after (ICC?=?0.88) visually censoring false positives. It had a positive predictive value of 71.6 %.Conclusion
Imaging at 7 T allows visualization and quantification of deep medullary veins. The presented method offers fast and reliable automated assessment of deep medullary veins.Key Points
? Deep medullary veins support the venous drainage of the brain ? Abnormalities of these veins may indicate cerebrovascular disease and quantification is needed ? Automated methods can achieve this and support human observers ? The presented method provides robust and reproducible detection of veins ? Intuitive quantification is provided via count and venous density maps12.
Objective
To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme.Methods
Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as complications. CTC and colonoscopy responses were compared using multilevel logistic regression.Results
Of 67,114 subjects identified, 52,805 (79 %) responded. Understanding of test risks was lower for CTC (1712/1970?=?86.9 %) than colonoscopy (48783/50975?=?95.7 %, p?<?0.0001). Overall, a slightly greater proportion of screenees found CTC unexpectedly uncomfortable (506/1970?=?25.7 %) than colonoscopy (10,705/50,975?=?21.0 %, p?<?0.0001). CTC was tolerated well as a completion procedure for failed colonoscopy (unexpected discomfort; CTC?=?26.3 %: colonoscopy?=?57.0 %, p?<?0.001). Post-procedural pain was equally common (CTC: 288/1970,14.6 %, colonoscopy: 7544/50,975,14.8 %; p?=?0.55). Adverse event rates were similar in both groups (CTC: 20/2947?=?1.2 %; colonoscopy: 683/64,312?=?1.1 %), but generally less serious with CTC.Conclusions
Even though CTC was reserved for individuals either unsuitable for or unable to complete colonoscopy, we found only small differences in test-related discomfort. CTC was well tolerated as a completion procedure and was extremely safe. CTC can be delivered across a national screening programme with high patient satisfaction.Key Points
? High patient satisfaction at CTC is deliverable across a national screening programme. ? Patients who cannot tolerate screening colonoscopy are likely to find CTC acceptable. ? CTC is extremely safe; complications are rare and almost never serious. ? Patients may require more detailed information regarding the expected discomfort of CTC.13.
Aim
To evaluate the pharmacokinetic profile (PK) and embolization effect of 70–150-μm doxorubicin eluting beads (DEBs) following intra-arterial injection (i.a.) in the rabbit liver VX2 tumour model.Materials and methods
In this ACUC-approved study, 25 white New Zealand rabbits were randomly assigned into a small DEB group (SDB, n?=?7, 70–150-μm DEBs), large DEB group (LDB, n?=?7, 100–300-μm DEBs), untreated controls (n?=?7), and doxorubicin controls (n?=?4, without tumour, received i.a. 12.5 mg doxorubicin). Plasma PK was assessed up to 180 min post-injection. Drug tissue and liver enzyme levels, radiologic tumor response and histopathologic tumour necrosis were assessed at 7 days.Results
Mean tumour doxorubicin concentrations were 922.83 nM (SD?=?722.05) and 361.48 nM (SD?=?473.23) for the SDB and LDB, respectively (p?=?0.005). There was no statistically significant difference in tumour doxorubicinol, plasma doxorubicin and doxorubicinol PK values. More beads were observed in the SDB tumours (p?=?0.01). Liver enzymes increased and gradually declined over the observation period, with significantly higher values in the SDB.Conclusion
In this preclinical study, plasma PK of i.a.-injected 70–150-μm DEBs was not different than that of 100–300-μm DEBs. More beads and higher tissue doxorubicin levels were observed in the SDB tumours.Key Points
? Small and large doxorubicin-eluting beads show similar plasma pharmacokinetic profiles.? Higher tissue doxorubicin levels were observed in the small bead group.? Liver enzymes were overall significantly higher in the small bead group.14.
Jesica?Makanyanga Balaji?Ganeshan Manuel?Rodriguez-Justo Gauraang?Bhatnagar Ashley?Groves Steve?Halligan Ken?Miles Stuart?A.?Taylor
Objectives
To associate MRI textural analysis (MRTA) with MRI and histological Crohn’s disease (CD) activity.Methods
Sixteen patients (mean age 39.5 years, 9 male) undergoing MR enterography before ileal resection were retrospectively analysed. Thirty-six small (≤3 mm) ROIs were placed on T2-weighted images and location-matched histological acute inflammatory scores (AIS) measured. MRI activity (mural thickness, T2 signal, T1 enhancement) (CDA) was scored in large ROIs. MRTA features (mean, standard deviation, mean of positive pixels (MPP), entropy, kurtosis, skewness) were extracted using a filtration histogram technique. Spatial scale filtration (SSF) ranged from 2 to 5 mm. Regression (linear/logistic) tested associations between MRTA and AIS (small ROIs), and CDA/constituent parameters (large ROIs).Results
Skewness (SSF?=?2 mm) was associated with AIS [regression coefficient (rc) 4.27, p?=?0.02]. Of 120 large ROI analyses (for each MRI, MRTA feature and SSF), 15 were significant. Entropy (SSF?=?2, 3 mm) and kurtosis (SSF?=?3 mm) were associated with CDA (rc 0.9, 1.0, ?0.45, p?=?0.006–0.01). Entropy and mean (SSF?=?2–4 mm) were associated with T2 signal [odds ratio (OR) 2.32–3.16, p?=?0.02–0.004], [OR 1.22–1.28, p?=?0.03–0.04]. MPP (SSF?=?2 mm) was associated with mural thickness (OR 0.91, p?=?0.04). Kurtosis (SSF?=?3 mm), standard deviation (SSF?=?5 mm) were associated with decreased T1 enhancement (OR 0.59, 0.42, p?=?0.004, 0.007).Conclusions
MRTA features may be associated with CD activity.Key Points
? MR texture analysis features may be associated with Crohn’s disease histological activity.? Texture analysis features may correlate with MR-dependent Crohn’s disease activity scores.? The utility of MR texture analysis in Crohn’s disease merits further investigation.15.
Purpose
The aim of this study was to evaluate the value of computed tomography (CT) spectral imaging in assessing the therapeutic efficacy of a vascular endothelial growth factor (VEGF) receptor inhibitor AG-013736 in rabbit VX2 liver tumours.Methods
Twenty-three VX2 liver tumour–bearing rabbits were scanned with CT in spectral imaging mode during the arterial phase (AP) and portal phase (PP). The iodine concentrations(ICs)of tumours normalized to aorta (nICs) at different time points (baseline, 2, 4, 7, 10, and 14 days after treatment) were compared within the treated group (n?=?17) as well as between the control (n?=?6) and treated groups. Correlations between the tumour size, necrotic fraction (NF), microvessel density (MVD), and nICs were analysed.Results
The change of nICs relative to baseline in the treated group was lower compared to the control group. A greater decrease in the nIC of a tumour at 2 days was positively correlated with a smaller increase in tumour size at 14 days (P?<?0.05 for both). The tumour nIC values in AP and PP had correlations with MVD (r?=?0.71 and 0.52) and NF (r?=?-0.54 and -0.51) (P?<?0.05 for all).Conclusions
CT spectral imaging allows for the evaluation and early prediction of tumour response to AG-013736.Key Points
? AG-013736 treatment response was evaluated by CT in a rabbit tumour model.? CT spectral imaging allows for the early treatment monitoring of targeted anti-tumour therapies.? Spectral CT findings correlated with vascular changes after anti-tumour therapies.? Spectral CT is a promising method for assessing clinical treatment response.16.
Antoine Hutt Alain Duhamel Valérie Deken Jean-Baptiste Faivre Francesco Molinari Jacques Remy Martine Remy-Jardin 《European radiology》2016,26(6):1521-1528
Purpose
To investigate the reliability of ungated, high-pitch dual-source CT for coronary artery calcium (CAC) screening.Materials and methods
One hundred and eighty-five smokers underwent a dual-source CT examination with acquisition of two sets of images during the same session: (a) ungated, high-pitch and high-temporal resolution acquisition over the entire thorax (i.e., chest CT); (b) prospectively ECG-triggered acquisition over the cardiac cavities (i.e., cardiac CT).Results
Sensitivity and specificity of chest CT for detecting positive CAC scores were 96.4 % and 100 %, respectively. There was excellent inter-technique agreement for determining the quantitative CAC score (ICC = 0.986). The mean difference between the two techniques was 11.27, representing 1.81 % of the average of the two techniques. The inter-technique agreement for categorizing patients into the four ranks of severity was excellent (weighted kappa?=?0.95; 95 % CI 0.93–0.98). The inter-technique differences for quantitative CAC scores did not correlate with BMI (r?=?0.05, p?=?0.575) or heart rate (r?=?–0.06, p?=?0.95); 87.2 % of them were explained by differences at the level of the right coronary artery (RCA: 0.8718; LAD: 0.1008; LCx: 0.0139; LM: 0.0136).Conclusion
Ungated, high-pitch dual-source CT is a reliable imaging mode for CAC screening in the conditions of routine chest CT examinations.Key points
? CAC is an independent risk factor for major cardiac events.? ECG-gated techniques are the reference standard for calcium scoring.? Great interest is directed toward calcium scoring on non-gated chest CT examinations.? Reliable calcium scoring can be obtained with dual-source CT in a high-pitch mode.17.
Objectives
To deploy and evaluate a stereological point-counting technique on abdominal CT for the estimation of visceral (VAF) and subcutaneous abdominal fat (SAF) volumes.Methods
Stereological volume estimations based on point counting and systematic sampling were performed on images from 14 consecutive patients who had undergone abdominal CT. For the optimization of the method, five sampling intensities in combination with 100 and 200 points were tested. The optimum stereological measurements were compared with VAF and SAF volumes derived by the standard technique of manual planimetry on the same scans.Results
Optimization analysis showed that the selection of 200 points along with the sampling intensity 1/8 provided efficient volume estimations in less than 4 min for VAF and SAF together. The optimized stereology showed strong correlation with planimetry (VAF: r?=?0.98; SAF: r?=?0.98). No statistical differences were found between the two methods (VAF: P?=?0.81; SAF: P?=?0.83). The 95 % limits of agreement were also acceptable (VAF: ?16.5 %, 16.1 %; SAF: ?10.8 %, 10.7 %) and the repeatability of stereology was good (VAF: CV?=?4.5 %, SAF: CV?=?3.2 %).Conclusions
Stereology may be successfully applied to CT images for the efficient estimation of abdominal fat volume and may constitute a good alternative to the conventional planimetric technique.Key Points:
? Abdominal obesity is associated with increased risk of disease and mortality. ? Stereology may quantify visceral and subcutaneous abdominal fat accurately and consistently. ? The application of stereology to estimating abdominal volume fat reduces processing time. ? Stereology is an efficient alternative method for estimating abdominal fat volume.18.
Objectives
To evaluate the feasibility of myocardial blood flow (MBF) by computed tomography from dynamic CT perfusion (CTP) for detecting myocardial ischemia and infarction assessed by cardiac magnetic resonance (CMR) or single-photon emission computed tomography (SPECT).Methods
Fifty-three patients who underwent stress dynamic CTP and either SPECT (n?=?25) or CMR (n?=?28) were retrospectively selected. Normal and abnormal perfused myocardium (ischemia/infarction) were assessed by SPECT/CMR using 16-segment model. Sensitivity and specificity of CT-MBF (mL/g/min) for detecting the ischemic/infarction and severe infarction were assessed.Results
The abnormal perfused myocardium and severe infarction were seen in SPECT (n?=?90 and n?=?19 of 400 segments) and CMR (n?=?223 and n?=?36 of 448 segments). For detecting the abnormal perfused myocardium, sensitivity and specificity were 80 % (95 %CI, 71-90) and 86 % (95 %CI, 76-91) in SPECT (cut-off MBF, 1.23), and 82 % (95 %CI, 76-88) and 87 % (95 %CI, 80-92) in CMR (cut-off MBF, 1.25). For detecting severe infarction, sensitivity and specificity were 95 % (95 %CI, 52-100) and 72 % (95 %CI, 53-91) in SPECT (cut-off MBF, 0.92), and 78 % (95 %CI, 67-97) and 80 % (95 %CI, 58-86) in CMR (cut-off MBF, 0.98), respectively.Conclusions
Dynamic CTP has a potential to detect abnormal perfused myocardium and severe infarction assessed by SPECT/CMR using comparable cut-off MBF.Key Points
? CT-MBF accurately reflects the severity of myocardial perfusion abnormality. ? CT-MBF provides good diagnostic accuracy for detecting myocardial perfusion abnormalities. ? CT-MBF may assist in stratifying severe myocardial infarction in abnormal perfusion myocardium.19.
Objectives
To estimate long-term durability in coiled aneurysms completely occluded at 6-month follow-up imaging, focusing on late recanalization rate and the risk factors involved.Methods
A cohort of 620 patients harbouring 698 completely occluded coiled aneurysms at 6-month follow-up was subjected to extended monitoring (mean, 24.5?±?7.9 months). Cumulative recanalization rate and related risk factors were analysed using Cox proportional hazards regression and Kaplan–Meier product-limit estimator.Results
Forty-three aneurysms (6.2 %) occluded completely at 6-months displayed recanalization (3.02 % per aneurysm-year) during continued surveillance (1425.5 aneurysm-years), with 26 (60.5 %) surfacing in another 6 months, 15 (34.9 %) within 18 months and 2 (4.6 %) within 30 months. Cumulative survival rates without recanalization were significantly lower in subjects with aneurysms >7 mm (p?=?0.014), with bifurcation aneurysms (p?=?0.009) and with subarachnoid haemorrhage (SAH) at presentation (p?<?0.001). Multivariate analysis indicated that aneurysms >7 mm (HR?=?2.37, p?=?0.02) and bifurcation aneurysms (HR?=?2.70, p?=?0.03) were significant factors in late recanalization, whereas a link with SAH at presentation was marginal (HR?=?1.92, p?=?0.06) and stent placement fell short of statistical significance (HR?=?0.47; p?=?0.12).Conclusion
Most (93.8 %) coiled aneurysms showing complete occlusion at 6 months post-procedure were stable in long-term monitoring. However, aneurysms >7 mm and bifurcation aneurysms were predisposed to late recanalization.Key Points
? Most coiled aneurysms showing complete occlusion at 6 months were stable. ? Forty-three aneurysms (6.2 %) occluded completely at 6-month follow-up displayed late recanalization. ? Late recanalization rate was 3.02 % per aneurysm-year during follow-up of 1425.5 aneurysm-years. ? Aneurysms over 7 mm and bifurcation aneurysms were predisposed to late recanalization.20.
Soo Chin Kim Ji-hoon Kim Seung Hong Choi Tae Jin Yun Jae Yeon Wi Sun Ah Kim Hye Young Sun Inseon Ryoo Sun-Won Park Chul-Ho Sohn 《European radiology》2016,26(10):3353-3360